Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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1114 Improving the Success of Your Practice with Carlo Biasucci, DDS: Dentistry Uncensored with Howard Farran

1114 Improving the Success of Your Practice with Carlo Biasucci, DDS: Dentistry Uncensored with Howard Farran

11/30/2018 1:51:25 PM   |   Comments: 0   |   Views: 394
Dr. Carlo Biasucci is a practicing dentist in Sault Ste. Marie, Ontario, Canada and most notably has tripled his practice in 3 years to a value of $8.2 million, but even more interestingly has done this while reducing his time in the practice every year. The practice has 9 dentists, 30 staff members, and sees over 175 new patients each month consistently for 3 years now. Presently he is treating patients between 5 and 7 days each month. He has removed dependence on him and shifted the running of the practice to his team, all while increasing the income from practice. Now, this wasn’t a straight line. Dr. Carlo suffered an injury in late 2012 than nearly ended his life, and as his doctors told him, would end his career in dentistry. After 6 months out of practice and getting back on the right side of things, he began his journey and quest for knowledge that allowed him to grow a very frustrating $2 million practice into a practice valued at $8.2 million in just 3 years. He documented every step, tested and turned it into a complete system that the practice runs on, and also has taken this model into the practices of dentists across North America under the banner of Elite Practice, a complete practice growth partner. Today’s interview will, I think, suggest new possibilities for you, your practice, your family and your future.

AUDIO-DUwHF #1114 Carlo Biasucci, DDS

VIDEO-DUwHF #1114 Carlo Biasucci, DDS

Howard: It is just a huge honor for me today to be podcast interviewing Dr. Carlo Biasucci, he is a practicing dentist and let me see if I can get this right, Sault Ste. Marie Ontario Canada which is a sister city on the u.s. Canadian border with Sault Ste. Marie Michigan correct?

Carlo: You got it

Howard: and most notably has tripled his practice in three years to a value of 8.2 million but even more interestingly has done this while reducing his time in the practice every year. The practice has nine dentists 30 staff members and sees over a hundred and seventy-five new patients each month consistently for three years. Presently he's treating patients between five and seven days each month he has removed dependence on him and shifted the running of the practice to his team all while increasing the income from practice. Now this was in a straight line Dr. Carlo suffered an injury in late 2012 that nearly ended his life and as his doctors told him would end his career in dentistry. After six months out of practice and getting back on the right side of things he began his journey and quest for knowledge that allowed him to grow a very frustrating two million dollar practice into a practice valued at eight million in just three years. He documented every step tested and turned it into a complete system that the practice runs on and also has taken this model into the practice of dentists across North America under the banner of elite practice and that website is A complete practice growth partner, today's interview will I think suggest new possibilities for you your success your family and your future. Man thank you so much for coming on the show before I ask your first question I want to tell you when I moved out here in 1987 there was like a 80 year old German lady and she escaped Nazism and she came over here before Adolf ruined everything and when she got here the Americans didn't recognize her license and I understand because America is the home of you know Ford and Chrysler and Germans are known for you know Mercedes and Porsche and Audi. So of course they couldn't accept their dental license and she was so sad and and she didn't have the money or time to go back to dental school to get an American license and she wouldn't got a lawyer lawyers said well you know what you you can't practice dentistry but what's cool is you can own a dental practice. So that forced her to just work on the business instead of working in the business just drilling filling billing 40 hours a week for 40 years and by the time I hooked up with her I mean she had four offices in Phoenix north south east west each one was doing two and a half million she was doing ten million and she told me that the worst thing that ever happened to her professionally turned out to be a blessing in disguise and now here you had the same fate were tell us about your injury that almost costs your life and then the make lemon out of lemonade's force you that now you can only work on the business set in the business what happened to you what was your injury?

Carlo: Yeah that's that story's very interesting so for myself my wife and I were on vacation actually went scuba diving, we love to do this at least a couple times a quarter we get out somewhere in the Caribbean and we were on our first dive of the week and that was the that was the end of it we had a normal diet profile everything was normal but when we came up I was a little light-headed but we got back to our condo in Grand Cayman and I just she tells me I don't remember it, I sat on the couch let's stare at the wall for about two hours and I thought okay it's not too bad, when I went to bed and I woke up on my body was numb. So we obviously I got myself to the hospital and I spent the rest of the week there not the worst place in the Caribbean to end up in the hospital they doing this job the doctors are great but the first guy I talked to said you know you're like this close days of coin toss I mean you're riding the razor's edge of it you could have killed you underwater or you could be where you are right now which is you know looks like severe concussion kind of range in terms of how this is going to play out for you but we know, we'll just see what happens. So I spent the entire week in and out of the hyperbaric chamber which is rather boring and then back in Toronto when we finally got back to Canada a week later. I did the same thing for about six weeks on and off I actually six weeks straight twice a day in a hyperbaric chamber and you know as you mentioned what's that with the German fellow German lady it's you know that's a time when you're going through that it seems like my god like this is crazy. I had no yes it's like if you break your leg you know now six eight weeks I'll be back in the game this was six six eight weeks in then I had no prospect of return to practice and the doctors were telling me well you may not you may have to look at something else and for me at that time it was not really a great option. I mean I was only six seven years into practice we had just built a brand new practice we were just you know getting ready to to make a run and that was the time when I just basically I stood back and I said you know just use this awesome opportunity and reevaluate because I wasn't really happy with that 2.4 million dollar practice as you mentioned, when it you know that that point which is conventionally successful by anyone's standards. I found an incredibly frustrated I hated it I was I was just running you know morning tonight I know all kinds of hours and just doing everything I could to build a business but it was frustrating I wasn't seeing you being able to I couldn't run any faster on that treadmill to get any more any more progress and so taking that force step back is what allowed me to just get that perspective that you just don't get any other way and think that that's set me on a totally different path. So that's that's our the story us as to what Canada what the catalyst was in terms of getting me yet you know from that frustrated in practice and then knocking me down for a little while to then get back up and make another run.

Howard: Well you know the the E-myth was one of the the best books ever written and it was a it was basically asking you know you know why do franchises like McDonald's have like a 98% success rate and why how come when they go open up next to say go to some small town in the 50s the 60s and set up next to you know the hamburger stand that's been there for 50 years and the E-myth concluded that the reason franchises were so successful so they had a team that just focused on the business whereas everyone they were competing against worked all day in the business making hamburgers fries and cokes and it's amazing the s&p500 you would think that that's the ultimate competition and the heavyweights used to spend 33 years on the s&p 500 and now it's down to 14 years. I mean people don't realize that the s&p 500 1950 88% of those companies were gone by today and the ones that were at the year 2000 this is now 2018 and half of those companies are gone and these are people that are ran by professional CEOs and MBAs and lawyers and they have the best businesses. So then you have a dentist and it's so it's so crazy because not only do you have to learn root canals, fillings, crowns, bleaching, bonding, veneers, invisalign, implants, you got to understand HR and marketing and taxes and I love your website because if you go to you asked for yes basically what you know he says you know where are you now number one click here if you're I'm frustrated my practice, number two my profit is shrinking, number three I want more new patients and four I'm already very successful. What are you seeing out there in the field who's clicking and who's reading your book, is it on Amazon?

Carlo: Yep

Howard: Yeah

Carlo: They can get it for free on our website

Howard: Oh you can get the book for free on your website okay well then we'll do that.  So who's calling you and what problems are you seeing in the real world today and also what percent of your business is Canadian versus U.S.?

Carlo: Okay and so get back to the you know they're do an initial growth of our practice post-injury when I was off the number one thing that I discovered is I had no idea about business and we know this I mean we know that we're not well trained coming out of dental school but I didn't realize how big the gap was so I spent all of that time off was just in total as about six months just studying everything that the best businesses out there do is related to mcdonald's and such learning about systems leadership all the things that you actually need in order to grow a practice. So who's calling us is we're seeing newer dentists who want to buy a practice and are looking at this as I don't want to bite off something more than I can chew and really just have no idea what it looks like because they understand the dental school side of it that initial introduction as an associate but even with my own associates you know they come to our office and you know within a few months they feel like this doesn't look that hard and I say okay well let's look under the hood now and it's like wow okay that's what it takes. So new dentists who wants to own a practice and there are many I want to get into that game, so what exactly should I be doing in terms of leadership systems training marketing how do I compete in the marketplace. Establish dentists who just want to grow I want to double my practice the most common thing is I'm at a million and a half of 1 over 3 or 4 and then we're finding quite a few folks who are you know in their 50s they want to retire in five years, how can I do what you did how do you how do triple your practice I want to get maximum value before I sell. So we're finding all three of those areas my in terms of canada-U.S. were about equal there's quite a bit on both sides of the border.

Howard: So to get the book you go and you enter your first name your email address and then you're gonna email in the book

Carlo: On the website there should be just click on the link and it'll take you to a form that effectively just ask you to tell us where to ship it to.

Howard: Okay

Carlo: Right at the top of the page this is claim your copy

Howard: Yeah I'm on I'm on the the iPhone smartphone site not the desktop

Carlo: Ok yeah I just click on your claim or copy and then the next page if you click on claim my free copy it'll just get you to input some information first name last name and then your shipping info and that should get you a book in your hands within a week or so.

Howard: So what do you mean when you talk about the mindset shift from new dentists to conventionally successful to self operating practice?

Carlo: Yeah good question, so new dentist it's all about I want to make some money, I want to pay off my debt, I want to you know grow practice really have no idea where we're going they wanted. We wanted to get when I was in that position I just wanted to get to what I thought was conventionally successful which is what I saw as a kid looking at my dentist and looking at to you know laterally at the time and I got to that point that the two two and a half million mark where the practice was successful everything you know from the outside looked great except I was running ragged and I had a you know a team that was you know I had to put everything on my shoulders and carry the business everyday, versus self self operating practice where effectively the team runs the show and that's a very different game. First of all in terms of value of your practice so you know that any business that the team runs the business of it's a it's less reliant on the owner is substantially orders of magnitude more valuable. So if you want to sell a practice the first thing I would do is try to remove yourself as the linchpin if those in my position now working five days a week the practice is substantially more valuable than if I were required to be here every day. So that's you know building that self operating side of it so the mindset shift is required to realize that you know it doesn't all have to go through your hands, a lot of dentists oh I've shared this you know this this sort of path in your life where they thought there was all your person and go to Staples to get stationery the only person to go to Costco to get toilet paper realizing that your team can do just about everything that you need to do to run the practice and often better than you can. You know getting that team to take the load off your shoulders is effectively the you know what gets rid of the stress in practice so you could just focus on mostly focus on treating patients and leading the team. So I want, in the ideal state the dentist becomes the leader of a team whose job it is to grow more leaders not the manager whose job it is to tie everyone's shoes and that's the mindset shift.

Howard: You know in the last seven years alone the S&P; 500 has shedded Eastman, Kodak, National Semiconductor, sprint, US Still, Dell even the New York Times and now there's these new companies that analysts includes you know Facebook ,PayPal, level 3 communications, Under Armour, Seagate Technology, Netflix, in Canada where you live is you see large group DSOs coming out dental services, dental support organizations. Who's the largest DSO in Canada?

Carlo: Right now dental Corp.

Howard: Dental Corp and I notice in your business model you have nine associate dentists working for you correct?

Carlo: Yeah

Howard: So we're and I I know you can't predict the future but let's go out fifteen years and what's that in fifteen years you won't even be as old as me that just you just ruined my day and you're 39 I'm 56 but let's go out 15 years is there a place for solo or is it or is the office going to be a group practice with like nine to get some skills of economy so you have enough revenue coming in where you can support a full-time office manager or maybe a marketing director or maybe an HR director maybe an accounting director and and where do you see the DSO is like Dental Corp in the Canadian market I mean how big do you think they're gonna get?

Carlo: So right now I think there are about 6,7% the Canadian market which is less than the US market I know substantially but they are making headway I think Dental Corp announced maybe 6, 8 months ago the billion dollars in financing one of the other corps has done similar in terms of financing so they've got tons of backing and the cool thing is to see these guys are in hard core acquisition mode and they're just buying up everything but what they're not doing is actually taking each of those businesses each of those practices is that they're buying and making them to be any better than they are. So what you've got is a ton of room for practices like this size you know we've got a few dentists together. I mean solo yes I think so low still competes I know I don't think solos going away just gonna be harder though the group practice is going to have an easier time from economies of scale from being able to cover market hours to be able to offer more services under one roof have that ability to have a significant marketing presence but I don't think that you know it's a requirement the DSO's, the management organizations they're not going to be able to produce the same experience that can be produced with a lead dentist who's fully engaged who's financially motivated to run the best business that he can or she can from a service level from a relationship level all those things that matter on retention or referrals they can't duplicate at the same level. I mean yes they have great management teams they have you know excellent leadership they have a lot of pieces in play but when it comes down to the practice I don't see that translating I mean you everybody can tell you that there's a lot of their patients come from the DSO practice across the road because of relationship experiences and such. So there's a lot of room if the dentist gets the experience right in the relationships right.

Howard: and is Dow is the DSO Dental Corp are they publicly traded?

Carlo: No

Howard: Ihat isn't that the ultimate red flag I mean why is it why is I mean you say they're getting a line of credit, so they're going and buying up all these practices and I get that I mean I mean the US stock market I mean we're sitting here right now and after Thanksgiving it's so weird a November 26 and the the stock market has literally been flat for the entire year so there's no gains and a lot of people think that could be an overvalued. So they look at these dental offices where a lot of these dentists you know have these high profit margins so it's easy to get a line of credit to go buy a bunch of dental offices but you believe they're not adding value to the offices they're buying and that they're all it they're just buying them that they're not actually fixing them up is that did I hear you right on that?

Carlo: Yeah but what I see just from my own observation if they buy a practice at a premium which is what's happening right now I think it's flattened out a little bit unlike they're going as crazy on the premiums that they were buying at however still it's it's a seller's market in Canada so it's I mean there's still paying more than market rate and that if their's a shift in leadership their's a shift, so if you take you know if you take a lead dentist who's grown a practice substantially and the team falls and the patients love that person and that is a leader who has grown leaders who are loyal to them and you take that person out or you know neuter the dog so to speak you know you take away their effectiveness as a leader by bringing in a corporate ownership structure that's going to wash down the practice to some degree. So you take that profitability you bring it down a little you know I don't see that I don't think I think that's probably one of the reasons why they're not publicly traded. I mean you're you're buying a three or four million dollar practice but you're adding that much in debt and the growth isn't there so I don't think that's attractive from an investor's perspective.

Howard: Absolutely when you but by the time they're doing a hundred million dollars in sales our revenue they have a hundred million dollars a debt. I mean my you're from Canada and my favorite shark on Shark Tank is Mr. Wonderful he's bald he's beautiful he's Canadian. I mean you couldn't get any of these DSOs past Mr. Wonderful he'd want to loan you a million dollars and he'd expect you to build a dental office or buy a dental office and then pay his million dollars back while the sales goes from a million to two million and it grows in profit to 4 million to 8 million at 10 million but that's not what you'd be saying to Mr. Wonderful you'd say well I would a borrow a million dollars to buy this office ok then what well I want to come back next week borrow another million buy another million and we're gonna do this and a hundred weeks from now we're gonna have a hundred offices doing a hundred million a year and we're gonna be a hundred million in debt. Mr. Wonderful would only say one thing he's what would he say, what would he say?

Carlo: Where's the cash flow in this deal

Howard: No he'd say you are dead to me you are dead to me get out of here I mean it wouldn't fly on Shark Tank and nobody in Nasdaq has touched any of these things yet you can get something completely useless and insane like snapchat to go public. I mean how does society need snapchat and that can go public but some dental services corporation that owns a hundred five hundred are damn near a thousand dental offices can't go public if that isn't the largest red flag I don't know who would be so are you friends with the the CEO of dental corporation in Canada mr. Graham Lawrence Rosenberg CPA

Carlo: I don't know him, no.

Howard: Any of the dentist like Dr. Andrew Melky? I'd love to get these guys on the show and by the way I want you guys to come on the show. I got an MBA I love business I mean I'm not throwing anybody under a bus I loved DSOs because they provide jobs for all the graduates and I have to tell you as a dentist who's had associates who owns Today's Dental for 31 years I don't want to hire a new grad, I mean my god they come out of school take some an hour to do a MOD composite and the warranty redo rates. I mean the last thing you want is some kid out of school to come in your practice I mean I've had this before where they they come in and the first year they place ten implants and then over the next five years I have to pay or have them redone you know. So nobody wants these new grads and they have to just get out and learn like if you join a football team you need to learn how to block and tackle and pass and receive and when you come out of school you need to learn how to do a filling and a crown and it just takes a couple of years. Now you have nine associates do you hire new grads?

Carlo: We do actually, I almost prefer new grads because I can get past the bad habits immediately and we've got a training process whereby within 90 days I can get them competent and I can get them really productive. So that's part of you know that again everything that we talk about on the elite practice side in our programs is stuff that was built out of our practice so you know I need to get new grads where I live in Sault Ste. Marie we're not exactly I mean this is a town or 70,000 people, the closest town of this size is 300 kilometers in any direction. So we're an isolated area to get a experienced dentist up here is tough new grads I can get them and I can keep her for two to three years max. So I gotta get him here I gotta train him quick and I gotta get them productive and I don't want to get stuck holding the bag when they leave so we have an intensive process where we train them and get them up to speed fairly quickly and you know some of that's mentoring someone that's over the shoulder there's the whole process that we've built around it but that's as I said that's these systems and processes are what we've turned into what we call the elite practice now it's borne out of how we did this.

Howard: Well you know you've said so you're in a town of 70,000 people and you said you're 300 kilometres away from what big town?

Carlo: Well the next nearest town to us heading towards Toronto is called Sudbury you know hundreds of thousand but it's another yeah.

Howard: and how far remember you're talking to a lot of Americans we only use metric when they're buying drugs and grams of heroin and cocaine they never use it for 300 kilometers what would that be about a hundred miles?

Carlo: 120 hundred 30 miles yeah

Howard: 120 miles, now I want to stop there do demographics matter do you think you're having more success because you're in that town is seventy thousand and the closest town of about the same size over a hundred twenty miles away versus do you think you could have pulled this off in downtown Toronto?

Carlo: It's definitely a different demographic between here and there but we do have about forty five dentists in this town. So that does I mean there is competition no question but what's happened what's different between here in Toronto so it's wrong oh you're like right in the downtown core which I mean that would be a tough start what I'm hearing from dental suppliers is a new start to downtown Toronto is a year to two years for a paycheck. So I wouldn't be trying to start there where your one dentist to five hundred thousand people maximum maybe 800 is probably the reasonable number there I hear we're probably double that but the difference is here in this kind of community you're not getting great insurance plans you're not getting how high dental IQ like you will pay my bills kind of patient you're blue collar some government services government plans like a Medicaid equivalent that sort of things. So it's you know you you may have more patients but you've got to turn more work in order to get this team buck at the end of the day so I don't think it's a significant advantage.

Howard: Well you know Henry Ford was the one you know a lot of people don't remember this story but when he started his car company there were 86 car companies but they were all making high-end luxury cars for rich millionaires billionaires kings and queens and he said if you focus on the rich classes you will be poor and eat with the masses and if you focus on the masses you'll be so richly with the classes and he made a car for the working man. I mean look at American the airline industry the number one airline is Southwest Airlines they flight 27 percent of all sea miles the biggest beasts are for the middle class Walmart, Costco, I mean look at wine mr. wonderful throw a dig at Mr. Wonderful even though he's bald and beautiful you know he's a big wine connoisseur but who sells the most wine in the entire world is Costco and they don't care about Mr. Wonderful's $100 thousand bottle you know they don't care about they don't care anything about that. Look at Budweiser they're their current commercial it's a diss on kings and queens being all elitist they said send them to the wine cellar this beers for the many not further you know the few and the elite. So all the money all the big money in the world is b to c products for the middle class so if you want to set up a dental office and that's why when you come to Arizona which by the way my town is 10% Canadians. I don't know if you know that or not 10% of all the houses in Phoenix are owned by Canadians they love this way and and now it's November 26 so you can spot a Canadian at least a block away you know why because yeah it's flippin freezing out this morning it's 59 degrees I have sweats a jacket a hat and I got my car I turn on my car seat and when you see someone walking down and they're in shorts and flip-flops means like damn Canadians. They they don't even know that 59 is freezing but anyway yeah you know what but you go to Scottsdale where everybody thinks all the money is and there's a dentist on every corner and they're all trying to do lifestyles of the rich and famous and then I look at all the dentists who are crushing it and they're not in Scottsdale they're in Phoenix, they're in Chandler, they're in Tempe, Queen Creek, Gilbert, Glendale, Peoria they're the people that go after the working man and it's and nobody wants to lecture on that because it's not sexy. I mean you'd rather go to a lecture that showed pictures of famous movie stars you know doing before-and-after veneers on that but there ain't no movie stars in Chandler there's none in Glendale there's none in Peoria. It's just the working man and those are where every dentist I know that's taking home three or four or five hundred a year they're always in the middle class you talk about the four pillars of any successful practice what are those four pillars?

Carlo: Yeah leadership, systems, training and marketing

Howard: Say that again that was too fast for my walnut brain.

Carlo: Leadership, systems, training and marketing and that's what our training platform our entire program is built around.

Howard: Can you take a deep dive into each one of those?

Carlo: Yeah absolutely so at a really high level leadership is you know if the dentist becomes the leader of the practice and their job is to grow more leaders to create a leadership structure in the practice you know everybody has that one or two really go to person in their office and what I'm saying is, is if we create a structure whereby the the dentist creates leadership and the leadership their job is to build more leaders then we build that practice and we level it up but through strategic hiring we can level up the entire practice, entire team over a year or two to where the team is now fully capable of driving the practice. So from a leadership perspective that's in a nutshell what we try to accomplish. Everybody has I think people that are far more capable and then we give them credit for we give a responsibility for it and yes we all have our bottom players but many of us have you know on our team some people who can step up given the opportunity in the confidence and obviously the guidance to get there. So we create that leadership, systems effectively as you said before you know why our franchise is so much more successful according to the e-myth folks and really if you have that systemized playbook if you have excellent systems to run the business and then you go and you find the best people that you can find to run those systems, rather than relying on superstars because I mean honestly McDonald's is not hiring superstars their hiring the best people they can find to run excellent systems. So as long as the systems are moving they're consistent experience is a reliable product it's give or take the same hamburger or whether it's in Rome or in Sault Ste. Marie, that's what we need to accomplish in our practices so regardless of which hygienists someone see's in our practice it should be exactly the same process exactly the same feel same relationship building and so on. So systemization of every single operation I used to joke I had this one assistant they probably all have this story who was the only person who could set up a crown of bridge or a root canal for me because she's the only one to get array and now or at the point where the next person who walks down the sidewalk in front of the office literally I could show them the system within five minutes they could setup any procedure if that's the level of systemization that if you run at that level it just takes all the stress that are practicing you can really ramp up, you can do a ton more work and it's a less stressful day for the doctor. With training obviously a consistent and strategic investment in training team we have to level these people up. So you have a team you know we don't invest any time in them but if you look at the most profitable businesses they're the ones who are spending the most money on training their teams on engaging those people so if you can create and engage team people who are happy with what they do they know what to do they have a lot of support they know they're constantly I mean even at this point our practice is doing great we still have Monte teammates we still have morning huddle's we still have weekly department meetings and we don't skip any of that ever for any reason because if you don't have that consistent push everything over time we'll just degrade to chaos. So if you let everyone default to what they want to do it'll be wherever is the least that they can get away with, so that's that continued push on training the systems is really important and then marketing is I mean obviously that's that's one of the big keys so what we do with our clients in our signature programs is rather than just teach them about marketing what to do we actually teach them how to do what to do how to do and then we do it for them. So a lot of our programs are built around here's exactly what we know works we're testing it right now in our practice here the numbers we're getting here the numbers clients are getting here's a done-for-you. That's one of the keys because really to get good at that it takes time and quite honestly a lot of dentists don't even want to talk about marketing because it's you know why should I have to market I'm good at what I do right.

Howard: Well let's go through I'm going to go through those four with some follow-up questions. When you go to leadership you know the natural selection for dentists physicians and lawyers or the people that came out of college with the highest GPA so they're usually introvert people that lived in a library are you born a leader, do you think the average dentist is born a leader and is this something you're born with or can it be trained because I know people don't like to talk about genetics that difference between boys and girls but even just this Thanksgiving I was sitting out there in my house amazed you know I grew up with five sisters and then I had four sons and now I got a whole bunch of grandchildren and I noticed on Thanksgiving Day out on the play in the backyard where the play house is right the girls were all would all go in and out of the play house through the door and they were all playing inside the house the boys only entered the play house by climbing in the window and at any given time one of the boys was on the top of the roof and of course one of them slipped and fell down and cried and you look thirty thousand fatalities a year from accidents in the United States are almost all males. So boys are born different than girls in my opinion I know that's a sexist statement but I always look at leadership and think when I see these these amazing dentists that are leaders I always wonder were they born that way or do you think you can be trained and educated to become a leader?

Carlo: Yeah I think I mean maybe if there's a genetic factor it's a jump start at best but absolutely I mean you know it's a good way back for me I was literally the shyest kid ever growing up I mean in fact I cried the entire first day of school the entire lot of people in this town and still talk about that okay. So I was not the person who was gonna get up in front of a room of people and talk about anything I mean I was the last thing I would have done so you know but over time out of necessity if you know if you want to become a dentist you have to come out of your shell to some degree but then when you really decide you want to grow there's no option, so there are two things I think one is you know self studies self-awareness you get better at it by watching things like those podcasts or reading books and such and you could develop that way. The other in the fastest I think is just getting in situations getting around other people who are where you want to be in your leadership ability will just fly. So if a dentists or any business owner wants to take their business from a million to five go hang around people who have five to ten million dollar businesses or 100 million dollar businesses outside of dentistry so circle of influence and your own drive to get better at it. I mean even at the point where you pre-accident me not a good leader post that's all I study, so I put a ton of attentional effort around it and that's that's one of the things I put almost well most of my energy went into how do I leave my team at the highest level, how can I get people to want to do what I need them to do for more than the paycheck and so on right so you study all these things and you spend hundreds and hundreds of hours watching videos reading books and so on and then getting into rooms or getting around mentors who are where you want to be and substantially more so, so your circle of influence plays a big role in that too I think.

Howard: Yes success leaves clues and and your a summary of the five people used for the most time with and so many dentists are stuck in there on their five best buddies from dental school who all hate dentistry and they just want to drink and they want to there's even a thread on dentist or dental town there or I want to retire like now it's like so you want to hang out with a bunch of people that hate dentistry so much they just want to retire now, why don't you go hang out with five people who are five dentists who are better than you at implants or business or marketing or whatever and so when you talk I loved your quote I loved it's profound that McDonald's systems are so good they don't they don't have to spend twenty thirty dollars an hour on brilliant people that can operate through chaos they their systems are so good they just need normal people at a normal regular minimum-wage person. So when you're looking at systems I want to nail down on specifics like what software do you recommend for a management information system or is that not a big part of your systems?

Carlo: Not a big part of it I mean whatever demo practice software a person is using is fun we don't do much in terms of actual systemization that way not through software we do have, so from a you know from tracking marketing we have custom software built out that we used for phone tracking in terms of close rates and that sort of thing. We have another system built out for case presentation follow-up but in terms of an overall practice system I don't use anything like that. What we recommend are...

Howard: but what software do you use in your office?

Carlo: We're just using den tricks as a management system in desktop.

Howard: So if some kid just walked out of dental school in the US or Canada and said what practice range of software do you recommend what would you recommend?

Carlo: I've only ever worked with dentists since I graduated.

Howard: So they're the market leader hands down. Now I think that what you next said you have your own software I mean the most when you study small business the most important job is who answers the phone they call it inbound sales and who calls customers that's outbound sale, that's the big dog that's the man that comes to work just like you and a white shirt and tie that's the highest-paid people the guys in the back making the sheet welding and those guys are wearing overalls come with the lunch pail and there's a $20 an hour employees and in dentistry it's completely reversed that guy back there instead of the overalls lunch pail that's the high paid glorious primadonna doctor and then the person answering the phone their's no training their's no phone tracking their's no clothes. You ask any dentist in you know in North America from from Mexico to Montreal you say how many inbound calls you have last month no idea how many of those inbound calls went to a scheduled appointment no idea of those scheduled appointments how many fillings I'm we're not talking about bleaching bonding veneers and all that crap we're talking about decay fillings how many did you diagnose how many were closed they don't know any of that stuff. Talk about the importance of the fact that no dentist on earth wants to hear that the lady answering the phone is more important to the disease missing and fill teeth rate of their community than glorious doctor drilling filling and billing, I mean she's everything and there's no systems no money I mean talk about that am I right or am I wrong?

Carlo: In any other business that the highest paying person is the Rainmaker if you can make the phone ring that's the highest paid job right and you said in our practices that's the you know often the the seat that changes hands the most it's the turnover area of the front desk and that person's supposed to do that while handling ten other things it's crazy. If you know and we do this every time we have a new client join us and we go through the phone training which is one of the first things that we do every person that joins my practice it's one of the first things they do if they're going to go near a phone they have to be fully trained and we actually have a full call center with five people in it now focused entirely on outbound and inbound and they have their exact priorities their stats everything we know right down to the letter. What I need them to do is to first realize exactly what their close rate is because they have no idea any calls you're getting and they don't know how many they're closing. Most people are hovering around 40 to 50% which is brutal because if you're spending 10,000 bucks in marketing half that's gone out the window. So we can get that close rate up to ninety ninety five percent it's not that hard every office we've been able to get up over 90 percent yeah almost doubling new patience right there those that come to the phone which is still number one way even today that people are calling a dental office or getting in touch with dental office, yes there's some Facebook yes or some other digital but phone is number one. Close rate has to be as high as possible but then we need to figure out I want to know of the calls we got how many were new patients how many were existing patients of those how many were closed how many were not closed and as I'm not closed I want to hear the call and I want to break that down by team member because if one of my team members is at a 60% close rate everyone else is at a 90 percent the person at 60 we got to yank off the phone we got to train a bit more. I'm not saying get rid of all I'm just saying they need some coaching and so you know exactly where to go put your energy put them back on the training platform or just spend some time listening to calls and reviewing but if you have the data you know exactly where to put your fingers so without data you're you're flying blind.

Howard: Well know most people think that McDonald's is the number one food franchise in the world it's actually subway and when you go get a job at Subway you have to go home and you have to log onto their deal and you have to take all these online training courses and they totally train and then I go get a job at an endodontist office where all we do is root canals, no training you're hired on Monday and you're thrown on the phones at 8:01 and there's just zero training it's like it's like everybody only cares about the footlong tuna fish sandwich the root canal nobody cares about that lady who answer the phone and so on this phone tracking software is this your own software or is there a software that you recommend for phone tracking or what do you use?

Carlo: So we have on our phone system it's just as the phone system itself as part of our Academy platform which is there's about 12 or so programs in there it's like the subway equivalents in dentistry. So it's a to see everything that you need to know run a high-level office now in there in the phone training part of that is at the end of that we install the phone system practice call tracker which is a system we've built and when we install that we use tracking numbers and we populate a dashboard our clients can log in they can look at their stats they can listen to calls everything interactive that's something we've had built out because I wanted something specific to the way we teach the way we operate so that's what we use in our practice for the last four or five years and that's what all of our clients are using right now.

Howard: That's just genius on have you posted about this on Dentaltown?

Carlo: No I should have.

Howard: Yeah you should start of threaded then when we do this podcast when it comes out on Dentaltown you can go to like YouTube and you notice I share and it gives you the link to the YouTube but then the next one over is embed and you can click that in bed and then on Dentaltown when you make a post as a YouTube icon you can click the YouTube icon and drop in the whole video but I mean you know my job I want to be a leader and these guys are coming out of school three four hundred thousand dollars in that and they think they think all the answers are in making and learning how to cook a new recipe and if they just get their business in order and they just start cash flowing and then you know when you come into a town that the main thing you should be caring about is that me coming to this community will make an impact on the disease missing and filled teeth of this community and when I opened up my office I was demoralized because Phoenix was the third largest unfluoridated city in America and I thought well this is just stupid to drill fill and Bill five days a week from age 25 to 75 and so I blocked off every Friday because I was so young and dumb I thought it'd take me like six weeks to get Phoenix fluoridated, it took every Friday for two years before Phoenix fluoridated the water and that was the and the Arizona State Dental Association gave me the Arizona award and it felt so fulfilling because the CDC sent me and Jack Dillenberg the Dean of the dental school a letter saying that their epidemiological models thought that the fluoridated water in Phoenix would prevent like 800,000 cavities a year and so now you come your dentist and you go back to Parsons Kansas and you want to make an impact and you don't even know how many people that called actually came in and you said the conversion rate is 40 to 50 percent you can get it to 90% in America all I hear is the the conversion rate is about a 1 in 3. So it must be better and so if you're if you have your seen 40 to 50 it might be because you're in a small rural town of 70,000 where there's a lot higher trust factor than in LA and Chicago and Manhattan and you know whatever but as far as same thing on the the cavities diagnosed to drill fill and bill it's only a third. Well how what kind of impact are you making on your community when you only drill fill and bill one out of every three diagnosed cavities I mean you could be twice as good of the doctor if you could get your conversion from one in three to two and three oh and not to mention double your money.

Carlo: Exactly and you've gotten two you've gone to the point where you've motive a motivated a person to even call your office because nobody miss dials a dentist and asks for an appointment. You've gone through the bother of motivating this person to look you up to dial your number and you didn't close them for some odd reason and it's usually they scared the person off, they answered questions they didn't ask, it so a whole whack of reasons why but if you could have just got that person in build some trust and rapport all of a sudden there you go you double your practicing it's not that hard. So it's just a matter of knowing their stats and doing something about it I mean we got statistics from you know coast to coast and North America wide, if it's a third it might even I hope it's not that bad but I mean what we're typically seeing is the forty forty five percent range but you know regardless if you're gonna get a person because most people we're not it's guys when we get patients at this level we're not stealing them from other offices I mean to a degree we are but most of them are you're just not going to a dentist right now you have to motivate this person to get off the couch to call you to do something proactive for the rural health and you know even as you said as a service I mean just get them in the chair right.

Howard: Well you know it's two things I think you're seeing forty to fifty percent because you're in rural where there's a lot higher trust there's a lot higher trust in rural than there is in big downtown big city but number two the other bias I think you're seeing is that the dentist who get help with practice management consultants they're already in the top twenty percent like I see it all the time you ask if he me single practice management consultant their numbers you say well like what is the average dentist the United States collecting revenue and they'd say oh about 1.2 1.5 it's like are you out of your mind it's we have we have data on that it's seven eighty from people who have PhDs and economics and so so why are they only saying 1.2 to 1.5 because the people reaching out to them that twenty percent, I tell them whatever every time I tell them they say well should I should I go learn how to place implants and should I should I go buy a laser and should i do LANAP and it's like why don't you spend half the money in LANAP on a practice management consultant and get your house in order get poised for growth and get rich then do all that stuff because they do all that stuff thinking that if I start doing LANAP or if I add Invisalign or if I start placing implants now all the sudden my receptionist is all of a sudden gonna magically learn how to answer the call and convert twice as many people to be scheduled and then we're gonna be able to present treatment and double our time it's like how does that happen.

Carlo: It's easier to swipe the credit card to take another course than it is just to realize that you need to sit down with Mary at the desk and train and that's a whole thing I don't even know where to start but I don't want to take a course right. So this is I think what happens and I mean I spent my first five years in practice I did a thousand hours of CE and I took every continuum out there I learn how to do just about everything you can do in dentistry and it was great except that I wish the first thing I did was learn how to be profitable and then add all this other stuff on top because you can create tiers in the practice you can create practice within a practice you can do high end as the owner doctor all that sort of stuff that you can you know shake this out any way you want but no profit means you cannot even stay in the game and you're right I mean I think that is very much the average seventy eight hundred thousand and when we get people who reach out to us in that range we put them in a certain level of the program where they're not going to be spending anywhere near what some of the top-level would make but at least exposes them to the mindset and the thinking of where they should be at that level before they can you know they're never going to grow past that if we don't get some of those my so shifts in place.

Howard: I think some of it also might be pride I think that a lot of dentists are very very I think a lot of them are proud they don't like they don't want they want everything I'm a really smart doctor I'm all this in a bag of chips and they really don't want someone to come in and and find out that oh my god this place is crazy you don't have any sense. They don't want I mean I mean think about it dentists in dental school if they got a test back and there are forty questions they can and they missed ten of them they feel horrible. I don't think a lot of them I think the people who are the most successful are humble they're the ones that can raise their hand and say I need help look look at how much more successful women are than men because women get help remember when I was little you know they thought that TMJ was mostly a female issue so everybody was studying estrogen like how does estrogen affect TMJ and then they found out through epidemiological that there was no difference between men and women it is that the women raised their hand and said hey I have horrible migraines and they go to get help and that's one of the largest reasons of why the average woman lives five years longer than the average man is because men just don't want to get help. So you got a lot of men that own their office they have a lot of pride they got big egos and they really don't want to call Carlo Biasucci and for him to come and say dude there's 40 questions on this test and you missed half of them. so I think prides a big issue do you or not really?

Carlo: It is I mean I was there myself and that pre-accident me not for a humble, big ego post a very very different game. Again realizing how big the gap was when you start to you know previously I did what I think all of us to do in the profession at that level is I went took a ton of courses, all I knew was I put myself in a room with other dentists you talked to other dentists and you know numbers come up with that sort of thing and well if you have kind of the biggest practice in the room you feel like oh like I know it all post-accident well first things I did was I went out and I got a lot of mentors hired consultants I did a lot of those things that I wouldn't have done previously and I put myself intentionally in rooms where people were running businesses not dental practices in the 50, 100 million range because I want to know what's inside their head and I'll tell you when you do that you become very humbled very quickly you realize how much you don't know and you realize how much that even these folks rely on outside help they wouldn't think twice to hire someone to come in and show them everything to do right because its speed to success right. You just compressed a learning curve by bringing in outside help and so that's you know if I can impress a lot on people then the importance of doing that is just getting out of your own way letting someone just show you it the fast path and then you can do it but spending 20 you know spending all this time in school in the build a practice you really have jumped through a lot of Hoops to get to the point where you can even you know hold the drill legally you know I know what that you know what that feels like and it's it's like at this point there's some deserve level when people start right and that there's no deserve in business it doesn't exist right you have to earn every day and that's the end of it. So getting into that that space where you realize that it's just much faster and easier if I get some help with this and get 100 on the test next days it's you know what we get in our own way you're exactly right.

Howard: and that's why I say it's pride and it's not sloth I mean the seven deadly sins are lust, gluttony, greed, sloth, wrath, envy, pride. I mean you can't become a doctor and have a sloth problem you're not lazy you're not dumb you know you're not I mean if you become a doctor I mean in the United States you know a dentist physician lawyer they're all in the top 5% income and it's that way in almost every country around the world whether you're developing nation or rich in the G Tony they're not lazy they're not dumb. I mean they're the that that's why I love my business the most because all my homies are dentist they're all readers they're all smart people I mean these threads on Dentaltown you can't post any single case concept thought and some dentists will say something where I'm like wow I never even I never even thought of it that way. I mean they're just so smart so it's not a dumb issue it's just a pride issue and it's a misallocation of resources. I mean like I say if you double your conversion rate you just double the increase your marketing I've always said the worst business to go into is marketing for new patients for dentist because you could get an a on what you do and then they drop every call coming in. So I want to go back to marketing cuz I what what do you mean by you know when we're selling the invisible I mean I know this the bottled water I know what Folgers coffee is I know what iPhone is but when you tell someone they have four cavities they have to trust you. How do you how do you add trusted authority to your marketing?

Carlo: Yes so that's probably the most important thing to build if you don't have that status then everyone in your community everyone around you on your block or whatever is equal in the patience eyes and while our regulatory bodies want us to think what that's what they want the public to believe is the dentist is dentist a dentist. I believe and it's I mean obviously if you can set yourself out as a category of one it's just that much easier for you, you start case acceptance before they even call. So one of the things that I've done for several years now many years is I'm the only dentist in my market that has written multiple books twenty-some-odd free reports we host webinars we host seminars we have all kinds of information pushed out to the public published newsletters all kinds of stuff online we're very active we're the probably the 10x Facebook following of anybody else around us and all of that is designed not to say we're better it's just to put out information about what your practice is, who you are, where you came from, things that regulators can't say anything about because it's good information but when a person comes to you for a cause of cosmetic consultation implant consultation Invisalign whatever and they leave with this box of stuff your books your reports all this information about you even if they never opened the cover they never read it and then they go get a second opinion from the person who maybe gives them an Invisalign flier. Their's a huge difference in the patient size as who's the expert here and that's how we set that up I don't like coupons discount marketing any of that stuff none of my ads have free anything or a limited time off whatever it's always get my free book request my information kit, get all this sort of stuff right so we build all that out for our clients and within a year or two this stuff really starts to snowball and you see what happens is now this person is the authority because they're the person who's pushing out the information the person is pushing out the content. You do the same thing online you get active on Facebook you're active on YouTube and next thing you know you're starting to get the media requests people are coming to you for interviews and all these sorts of things happen and one you know I'm still just a dentist there are my skill set is very equal to majority of dentists out there but I'm perceived here at a very different level and that's strategically built. So that's what I mean by Authority platform and you're so many many examples I could give but that's the strategy.

Howard: You know what's amazing as we talk about Southwest Airlines you know earlier number one airline 27 percent of all sea miles, I've had so many dentists come on this show and they were discussing like say dental implants or they were cosmetic dentistry or whatever and they've emailed me back they said dude you know that you put that on YouTube I've gotten so many patients from that because here they were a dentist in New Jersey doing implants and then they're saying that this guy is being interviewed on this national show and then what surprises in the most is how many people were actually flying in to see them and then when I look at when I look at websites the people want to see their own work like if I had to have say I have a facelift and I go to your website and there's none of your before and after work and then I go to another guy's website and he's got ten or fifteen they say these are Dr. Carlo Biasucci work these were done by him himself in his pages. Those are the people that are getting patients to jump in an airplane and fly across and I was talking to a friend of mine in Kansas City and he felt so bad because he was doing this big implant case and the guy flew and I think was from Fort Scott Kansas and the guy he actually knows the guy in Fort Scott Kansas who's just crushing it and the diplomat the International Congress of Implantology, he says dude if you go to his website he doesn't have one before an after case but when this guy comes in lectures to your Study Club he shows 20 cases and they're not even on his website he's like it's like crazy crazy. I'm gonna go I'm gonna go back to on the website deal 168 hours in a week when you're when your software is recording this phone conversation how big do you need to open that funnel is that a big factor I mean most dentists answer their phone 8:00 to 5:00 Monday through Thursday and most of the research I see that's only one about 50% of the incoming calls come in which is 32 hours a week which is 19% of the 168 hours a week and the other half for coming in the other 81 percent of the hours and you're how important is it to open that funnel to answering live calls like if you're open 8 to 5 well right now you know when I drive into work you know the freeways are packed from about 7:00 to 8:00. So is that when they're calling and you should be answering the phone or does that not really matter?

Carlo: Yeah market was seven to seven and the reasonable about it

Howard: Seven to seven answering the phone or seven to seven answering the phone and making the pizza and the root canals?

Carlo: I think you can be open you know 8:30 to 5:30 kind of thing I mean we run eight to six here but and answering the phone seven two seven six days a week is what the market wants.

Howard: Their you go, absolutely

Carlo: Yeah and it's really easy to do that I mean very simply you just get a self when you pay a staff member and that's that we still pick up at least I would bump 50% new patients from those calls most people are gonna call you at 5:30 or 6 o'clock that's just cuz they just you just got home they just remembered if you don't and all they have to do is say hey yeah come on in while morning at whatever time because they have to times on a piece of paper they're left with it's that easy if it's an emergency see at 8:00 as simple if you have the systems ready.

Howard: Well I know I know how my homies think they're gonna think well won't they just leave a message and we'll call them back at 8:00.

Carlo: No statistics on that are terrible I was a message nobody calls back it's like 80% of people will not call back 84% I believe is the current statistics I believe.

Howard: Yeah humans only talked to humans and mostly dogs that secrete the same levels of oxytocin dopamine I call it the scream factor like like nobody will eat nobody wants to eat a dog or a puppy because it would cry when you killed him but when you kill a salmon it does it doesn't scream no one cares. They talk to they talk to humans and dogs and if you're crazy cats which is my favorite animal but they don't talk to answer machines and if you see someone talking to the answer machine this should be the same thing as if you walk through the park and see someone talking to a tree. I mean they're you know something something's wrong when you're talking to a tree or an answer machine they just don't do it there's no stats to it so so they if they answered the phone 7 to 7, I mean I mean that would just be a huge game-changer wouldn't it.

Carlo: Absolutely just in itself so if somebody's watching this and you want to take one thing away to do immediately just answer the phone just cover the phone 7 - 7, 6 days a week get a cell phone give it to a staff member pay him for it and there you go.

Howard: So what so if someone happen to say to you what is better if you had to get an A in one area and a C in the other would you rather have the A in marketing and a C on phones or would you rather have A on phones and a C in marketing?

Carlo: You gotta crush the phone conversion on the phone is switch you can blow all kinds of money marketing and not convert it's it's very simple I mean it's it's so easiest to do the most profitable thing to touch because you're spending zero money and you're getting revenue out of it it's I mean absolutely hands-down.

Howard: Heartland dental has over 950 offices they just got bought up by a KKR and Rick workman said on this show that their call center it's their secret sauce. I mean he's telling his homies look here's here's how we're beating you we answer the phone but they take it a step further when they answer that phone 7:00 to 7:00 that lady can dial in and schedule an appointment so I mean if Carlo Biasucci calls up and says and Rick says it's bizarre like people call like 7:00 p.m. on a Friday night but though they'll convert right there no I oh yeah when we'd like to come in and and so these guys are because I think I want an all the DSO guys to come on here because I think competition is good for any industry. I mean you have the dentist and of course the dentists they all had it their way they do one crown on Monday from 8:00 to 9:00 in charge 1 million dollars and dental insurance and pay for it all that the patient had it their way all dentistry would be free and paid for by Bernie Sanders and that the insurance companies had it their way we'd all be on a PPO and they'd lower fees 5% every year. So you know there there's many stakeholders in this game but I think what's best for the patient is competition and I think whenever a country has free trade and like I think most PhD economists would wipe out every trade deal on the planet today and said instead of having all these games and rules let's just make it free trade and then the more and everybody that buys the lobbyists in DC is trying to restrict trade, they don't want competition. So I think DSOs are healthy I think when they come into a market they make dentists to pay attention to the business side of dentistry than just on the the preparing the dentistry.

Carlo: Exactly wakes everybody up shakes up the market a little bit but they're not this giant that can't be beat so everyone can't you can no longer just rely on what's always been working but it's not difficult to beat them absolutely not the competition is healthy.

Howard: Yeah yeah and when you do beat them I mean I'm not even that impressed because number one they can't even go public number two anybody that cries that practice across the room DSOs routinely gets to do second opinions on these big $5,000 cases when they find that they're very aggressive treatment planners. So that's so the I can't believe we went over an hour, dude I could talk to you all day your website is What are my homies gonna find if they go to

Carlo: First thing you see at the top of the page is a form to get my book for free the elite practice formula just follow the form fill it out we'll send you a copy of the book and check out we're about and their's more information on there about what we do some client feedback and that sort of thing but you start with the book get a read about what we're about and what we do that's a great start.

Howard: and you can also buy it on Amazon too?

Carlo: Yeah you buy on Amazon Kindle version this audiobook so you go...

Howard: Ok so on Amazon it's still just a digital version?

Carlo: Amazon's got Kindle they've got the printed version I believe this audible version as well.

Howard: but the free copy on your website is that a is that a digital version or you can get actual book?

Carlo: Yeah oh yeah the actual printed copy this guy's coming to you.

Howard: Nice because I hate to say this cuz it's a slam on me but I'm 56 I want to hold a book and I've tried to do that digital thing and I try to do that but I don't know I've read a thousand books and I just love to sit in my chair and usually it's on an airplane and read the book but hey I just want to tell you that the only reason this show is a success is because I'm able to get people like you to come on. Thank you so much for spending an hour of your valuable life on my show talking to my homies, thank you so much for coming on today.

Carlo: Thank you for having us absolute pleasure.

Howard: and start a thread and if you're if you're shy on Dentaltown, say I just finished the podcast with Howard and he told me to talk about this but again dude thank you so much for coming on the show I hope you have a rockin hot day.

Carlo: Awesome thank you, you too appreciate it. 


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